Table 4 Learning, expertise and applications of diaphragm ultrasonography in clinical practice
Learning and expertise | |
Excursion Measuring diaphragm excursion is an easy skill and with steep learning curve Thickness Measuring diaphragm thickness is not an easy skill and has a slow learning curve Excursion and thickness A teaching program to learn diaphragm ultrasonography should include anatomy of the diaphragm, anatomical landmarks for measurement, supervised practice and a practical skill examination A minimum of 40 (ideally bilateral) examinations, of which at least 20 should be under (indirect) supervision of an experienced teacher, are needed for independent use in daily practice | |
Daily practice | |
Skills necessary in daily practice Excursion measurements are a necessary skill for daily practice Thickness measurements to calculate diaphragm thickening are a necessary skill for daily practice Useful indications Monitoring diaphragm function and determining dysfunction Prognostication of difficult weaning, extubation outcome and length of ICU stay Detect patient–ventilator asynchrony and titrate ventilator settings |